title: The HIV Virologic Outcomes of Different Interventions Among Treatment-Experienced Patients With 2 Consecutive Detectable Low-Level Viremia.
abstract: BACKGROUND
  Approaches to treatment-experienced HIV-infected patients with persistent low-level viremia are limited by current commercial resistance genotyping assays when the viral load (VL) is <500 copies/mL. The best intervention to achieve virologic suppression in this population is unclear.
  
  
  METHODS
  This is a case control retrospective chart review study of 149 HIV-infected patients with a VL of 50 to 1000 copies/mL. Patients were in either regimen unchanged group or intervention group (intensification of regimen or switch without guidance from resistance testing). End point was VL < 100 copies/mL.
  
  
  RESULTS
  At 6 months post change, 30.8% of patients with intervention versus 36.6% with no intervention achieved a complete virologic suppression. There were no statistically significant differences between these 2 groups (P = .254). The majority of patients without regimen change eventually progressed to complete virologic failure.
  
  
  CONCLUSIONS
  Patients with persistent low levels of viremia are likely to progress to have virologic failure. This supports the adoption of a more proactive approach to treatment and more sensitive technique to identify drug resistance.
authors.affiliation: University of South Florida, College of Medicine, Tampa, FL, USA.
authors.forename: Tri
authors.initials: T
authors.lastname: Pham
authors.forename: Sally
authors.initials: S
authors.lastname: Alrabaa
authors.forename: Charurut
authors.initials: C
authors.lastname: Somboonwit
authors.lastname: Le Hung
authors.forename: Jose
authors.initials: J
authors.lastname: Montero
mesh_terms: D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D012189:Retrospective Studies; D019562:Viral Load; D014766:Viremia